Population Based Health Care

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A woman with Alzheimer's disease has significant apraxia and poor hygiene. Which intervention would be most appropriate for ensuring that the patient completes a shower?

  • A. Remind her of the need for a shower and where the shower is, and repeat this every 30 minutes until the shower is completed.
  • B. Discuss with her the importance of showers as part of daily self-care, and elicit and resolve any obstacles to the patient's showering.
  • C. Walk her to the shower, and provide occasional reminders of what she should do next if she seems to be unsure or begins to repeat previous actions.
  • D. Walk her to the shower, assist her to undress, start the water, supply the soap and washcloth, and instruct her to rub her face with the washcloth.
Correct Answer: D

Rationale: The correct answer is D because it provides the most direct and hands-on assistance to ensure completion of the shower. By walking her to the shower, assisting with undressing, starting the water, and providing necessary supplies and instructions, the patient is guided through each step of the showering process. This approach is essential for someone with significant apraxia and poor hygiene due to Alzheimer's disease.

Choice A is incorrect because simply reminding the patient every 30 minutes may not address the physical assistance needed for shower completion. Choice B is also incorrect as discussing the importance of showers may not be enough to overcome the challenges of apraxia and poor hygiene. Choice C is not as effective as choice D as occasional reminders may not provide the comprehensive assistance required for the patient to successfully complete the shower.

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Explain four (4) the behavioral features of Anorexia Nervosa

  • A. Restricting food intake
  • B. Excessive exercise
  • C. Body image distortion
  • D. Fear of weight gain
Correct Answer: A

Rationale: These behaviors reflect the core features of anorexia: restriction, overactivity, distorted perception, and weight obsession.

Multiple personality or dissociative identity disorder often begins

  • A. as a result of combat exhaustion
  • B. in adulthood as a response to unremitting phobias
  • C. as a consequence of post-traumatic stress disorders
  • D. in childhood as a result of unbearable experiences
Correct Answer: D

Rationale: Dissociative identity disorder typically originates in childhood from severe trauma, such as abuse, leading to identity fragmentation.

The population of Boston today is compared to its population after World War

  • A. The same
  • B. Slightly higher
  • C. Considerably higher
  • D. Less
Correct Answer: C

Rationale: Boston's population has grown considerably since post-World War II due to urban development and economic opportunities.

A 17-year-old client is admitted to the ED after being alternately hyperalert and difficult to arouse. His symptoms all started within the last few hours, during which time he became disoriented and confused. His behavior was agitated and restless, and his memory was impaired, especially for recent events. The client displayed some delusions and misinterpretations of his surroundings. The nurse knows she needs to assess the client further for:

  • A. Dementia
  • B. Depression
  • C. Delirium
  • D. Amnesia
Correct Answer: C

Rationale: The correct answer is C: Delirium. Delirium is characterized by acute and fluctuating changes in cognition, attention, and awareness. The client's sudden onset of symptoms, including disorientation, confusion, agitation, restlessness, impaired memory, delusions, and misinterpretations of surroundings, align with the hallmark features of delirium. The nurse needs to further assess the client for delirium to determine the underlying cause and provide appropriate interventions promptly.

Incorrect choices:
A: Dementia - Dementia is a chronic, progressive condition characterized by gradual cognitive decline. The client's acute onset of symptoms is not consistent with dementia.
B: Depression - Depression typically presents with persistent feelings of sadness, hopelessness, and loss of interest, which are different from the acute and fluctuating cognitive changes seen in delirium.
D: Amnesia - Amnesia refers to memory loss, which is only one aspect of the client's presentation. Delirium involves a broader range of cognitive

A friend brings a teenager to the emergency department. The friend found the patient unconscious in a bedroom at a party. Semen is observed on the patient's underclothes. Priority actions by the nurse should focus on:

  • A. Preserving rape evidence.
  • B. Maintaining the patient's airway.
  • C. Obtaining a description of the rape.
  • D. Determining what drugs were ingested.
Correct Answer: B

Rationale: The correct answer is B: Maintaining the patient's airway. This is the priority action because the patient is unconscious and airway patency is crucial for survival. Preserving rape evidence (A) can be important, but the patient's immediate health takes precedence. Obtaining a description of the rape (C) can wait until the patient's condition stabilizes. Determining what drugs were ingested (D) is important but secondary to ensuring the patient can breathe.

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